Provider Demographics
NPI:1407849227
Name:RYAN, SARAH DELORES (MD)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:DELORES
Last Name:RYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:DELORES
Other - Last Name:BRAUNREITER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1515 SW CARY PARKWAY
Practice Address - Street 2:SUITE 220
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6224
Practice Address - Country:US
Practice Address - Phone:919-387-3160
Practice Address - Fax:919-387-3165
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200500247208000000X
VA0101229129208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901105Medicaid
NC5901105Medicaid